IDEXX Reference Laboratories

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1 IDEXX Reference Laboratories 2014 IDEXX RealPCR Test Directory IDEXX RealPCR Directory i

2 Assistance by Phone: Customer Support Hours (Eastern Time) Monday Friday: 7:30 a.m. 2:00 a.m. Saturday: 8:00 a.m. 11:00 p.m. Sunday: 10:00 a.m. 8:00 p.m. Telephone Options* Press For 0 Direct access to a 5-digit extension 1 Add on a test, for test status, results or protocol questions 1 Add on a test 2 Check the status of your test or request a copy of results 3 Protocol questions 8 Repeat this menu 9 Return to the main menu 2 Test pricing, billing adjustments or to pay your bill 3 Schedule a courier pick-up, order laboratory supplies or allergy/immunotherapy 4 All medical consultations 2 For consultation on a dog or cat 1 To discuss results with a specialist 2 To discuss treatment with an internist 3 For an oncology consult 4 For a dermatology consult 3 For an equine specialist 4 For an avian and exotic specialist 5 For an oncology consultant 6 For a dermatology consultant 7 For a specific pathologist 5 VetConnect or VetConnect PLUS support 1 VetConnect 2 VetConnect PLUS 6 In-practice tests or analyzers *Telephone options can be selected as soon as the greeting begins. Symbol key Specimen requirements Turnaround time (working days) IDEXX RealPCR Directory

3 Table of Contents.. IDEXX RealPCR FAQs. 2 IDEXX RealPCR Specimen Collection Guidelines. 5 Canine and Feline RealPCR Tests. 7 Gastrointestinal Disease. 7 Kidney/Liver Disease. 10 Neurologic Disease. 11 Reproductive Disease. 12 Respiratory Disease. 14 Systemic Mycoses. 17 Tick/Vector-borne Disease and Anemia 18 Additional Canine and Feline Tests. 24 Equine RealPCR Tests 28 Gastrointestinal Disease. 28 Neurologic Disease. 30 Reproductive Disease. 31 Respiratory Disease. 33 Additional Equine Tests. 36 Exotics RealPCR Tests. 37 Alphabetical Index by Organism. 38 IDEXX RealPCR Directory

4 IDEXX RealPCR FAQs What is PCR? Polymerase chain reaction (PCR) is a molecular technique that exponentially amplifies a specific region of DNA. The large number of copies of DNA produced permits detection of infectious agents in specimens. What is an IDEXX RealPCR test? How is it different from conventional PCR? IDEXX RealPCR tests are run by real-time PCR. Real-time PCR is faster and more sensitive and utilizes a closed-tube system that virtually eliminates contamination and false positives a problem with conventional PCR. Real-time PCR also allows for testing for multiple pathogens on a single specimen and enables not only detection of pathogens but also quantification of the amount of genetic material in a specimen. What additional steps are taken to prevent contamination and ensure accurate results? IDEXX s molecular diagnostic laboratories are dedicated units separate from other testing areas. They offer maximum security through separation, air pressure differences and a QA/QC management system to control the PCR process, specimen integrity and facility safety. When is PCR testing indicated? PCR testing should typically be reserved as a diagnostic tool for sick animals to confirm or rule out the presence of infectious agents. PCR can detect the actual presence of the pathogen before antibody response occurs, making it extremely valuable for early detection. What does a positive PCR result mean? A positive PCR result indicates that the nucleic acid (DNA or RNA) of that organism was detected in the specimen submitted, indicating infection with the organism. A positive result should always be interpreted in light of the clinical signs of illness to determine clinical significance and whether treatment is indicated. What does a negative PCR result mean? A negative PCR result indicates that the nucleic acid (DNA or RNA) of that organism was not detected in the specimen submitted, which suggests that the animal s disease is not caused by the organism. However, a negative PCR result may be caused by the numbers of organisms being below the limit of detection of the PCR assay, decreased numbers of organisms following treatment or present in a chronic carrier state, or the occurrence of a new strain not detected by the PCR assay. Does PCR differentiate between vaccination and infection? For inactivated vaccines, PCR does differentiate between vaccination and infection. In general, PCR does not pick up the DNA component of inactivated vaccines administered systemically. For modified live vaccines, PCR may detect viral DNA/RNA for a few weeks after vaccination while the vaccine virus is replicating. Quantification of viral DNA/RNA in the specimen by real-time PCR may be used for some pathogens (e.g., distemper virus) to distinguish between vaccination and wild-type infection. 2 IDEXX RealPCR Directory

5 IDEXX RealPCR FAQs What are IDEXX Quant RealPCR tests? IDEXX Quant RealPCR tests utilize the quantitative results that real-time PCR provides to give additional information to help interpret positive PCR results for certain pathogens. For example, the Canine Distemper Virus (CDV) Quant RealPCR Test can be used to determine if a positive PCR result is likely a result of recent vaccination or from wild-type infection. The Clostridium perfringens enterotoxin (CPE and CPA) Gene Quant RealPCR tests can be used to help decide whether the enterotoxins are likely contributing to diarrhea. The Feline Herpesvirus Type 1 (FHV-1) Quant RealPCR Test provides information about whether a positive herpesvirus result reflects active or latent infection. The Leishmania spp. Quant RealPCR Test on whole blood helps solve the dilemma of whether or not to treat by differentiating between Leishmania-infected but clinically healthy dogs with a low parasite burden and those dogs with active leishmaniosis and a high parasite burden. Quantitative testing for Leishmania on bone marrow is recommended to monitor treatment success. Additional Quant RealPCR tests are under development. Should other diagnostic tests be performed in conjunction with PCR testing? As with other diagnostic testing, PCR should not be used in isolation. The clinical signs of the patient and additional diagnostic testing should be considered when appropriate. In fact, several of our PCR panels include serology, for example, Tick RealPCR Panel with Lab 4Dx Plus and Anemia RealPCR Panel with FeLV/FIV by ELISA. Other panels include reflex cultures if PCR results are positive. More about PCR testing Real-Time PCR The real-time detection mode is made possible by using fluorescent tags built into the real-time PCR tests. Based on the real-time detection, quantitative information is readily available for downstream use. This feature has been used to develop quantitative PCR tests, which provide additional clinical information. Automation PCR is a process composed of two steps: DNA or RNA extraction followed by the real-time PCR reaction. High levels of automation during the nucleic acid extraction allows us to achieve high consistency and yields, minimizes errors and speeds up the process. Because of the highly automated first step in our process, diagnostic specimens are ready for PCR in less than 2 hours. Highly affordable and fast real-time PCR testing Our state-of-the-art real-time PCR equipment allows testing of large numbers of specimens within a very short time. Turnaround time of a PCR specimen (nucleic acid extraction and testing) once received at the PCR laboratory is less than 5 hours. Images courtesy of Roche Molecular Systems, Inc. IDEXX RealPCR Directory 3

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7 IDEXX RealPCR Specimen Collection Guidelines PCR testing offers a versatile testing modality for infectious diseases. However, accurate results depend on collecting the appropriate specimen type for the clinical manifestation. Provided below are detailed protocols for each sample type. All specimens should be stored and shipped refrigerated, unless otherwise indicated. Specimens should be collected prior to antibiotic, antifungal or antiviral treatment directed against the organism of interest, or collected at least 2 weeks after withdrawal of these medications. Specimens received within 72 hours of collection are preferred, but most specimens are stable for up to 10 days if stored refrigerated, unless otherwise indicated. Vaccination with an attenuated or modified live vaccine may result in positive PCR test results for up to a few weeks postvaccination. Every RealPCR specimen submission is processed with up to 7 quality controls. If a specimen fails the preanalytical quality control (DNA and RNA), a repeat extraction is attempted. If quality control criteria are still not met for a particular diagnostic specimen, the submitting veterinarian will be contacted and encouraged to submit a fresh specimen at no additional charge. Whole Blood: 2 ml (0.1 ml minimum) EDTA whole blood (LTT). Feces: 5 g (1 g minimum) fresh feces in a sterile container (preferred) or empty, clean container. Urine: 2 ml (0.1 ml minimum) urine in a sterile container. Fluid (CSF, pleural effusion, respiratory wash specimens, uveal fluid, ascites, abscess aspirates, etc.): 0.5 ml (0.1 ml minimum) fluid in a sterile tube (LTT [preferred], RTT or plastic tube). Swabs: Submit dry, plastic-stemmed swabs, without transport media, in an RTT or in a empty, sterile tube. Respiratory specimens may include a deep pharyngeal swab (with visible organic material on swab; please rub firmly), and a conjunctival swab (wipe eye clean; swab inside of eyelid), which can be submitted together in the same tube, or a nasal swab (equine respiratory panels or systemic mycoses). When acquiring a pharyngeal swab, precautions should be taken to prevent patient from biting and/or ingesting part of swab. Collect specimens prior to fluorescein staining. Tissue Aspirates: Submitting tissue aspirates on a swab (see below) improves stability of the specimen. 1 3 air-dried, unstained slides (keep refrigerated) are also acceptable specimens but may result in lower sensitivity. Suggested Protocol for Tissue Aspirates: 1. Aspirate tissue into the hub of the needle using standard techniques. 2. Remove the syringe from the needle and fill syringe with air. 3. Reattach the syringe to the needle and squirt out aspirate onto the end of a dry, plastic-stemmed swab. 4. Submit the swab in an RTT or an empty, sterile tube; keep refrigerated. Tissue Biopsies: PCR testing can be performed on previously submitted histopathology specimens (formalin-fixed, paraffin-embedded tissue). Fresh, refrigerated tissue specimens submitted within 24 hours of collection are also acceptable. Freezing is not recommended unless the specimen can be maintained frozen until arrival at the PCR laboratory. IDEXX RealPCR Directory 5

8 Symbol key Specimen requirements Turnaround time (working days)

9 Canine and Feline RealPCR Tests Gastrointestinal Disease Quickly and accurately identify multiple infectious causes of gastrointestinal disease from a single fecal specimen. New for 2014, canine circovirus has been added to the canine diarrhea RealPCR panels (see Canine circovirus: an emerging pathogen on page 9). Consider testing: Dogs and cats with diarrhea, which can be: Acute, chronic or intermittent Small-, large- or mixed-bowel Dogs and cats with unexplained weight loss To identify and minimize human exposure to zoonotic pathogens Gastrointestinal disease specimen requirements unless indicated otherwise: 5 g (1 g minimum) fresh feces in a sterile container; keep refrigerated. Collect specimen prior to antibiotic administration. When ordering a panel that includes reflex Salmonella or Campylobacter cultures, also submit 3 5 g fresh feces in fecal culture transport media. for RealPCR panel; allow additional time for culture if indicated Diarrhea RealPCR Panel (Comprehensive Plus) Canine 3257 $ Campylobacter coli, Campylobacter jejuni, canine circovirus, canine distemper virus (CDV), canine enteric coronavirus (CECoV), canine parvovirus 2 (CPV-2), Clostridium perfringens alpha toxin (CPA) gene Quant, Clostridium perfringens enterotoxin (CPE) gene Quant, Cryptosporidium spp., Giardia spp. and Salmonella spp. RealPCR tests. If the RealPCR test is positive for Campylobacter spp. or Salmonella spp., a culture on selective media (with susceptibilities for Salmonella) will be automatically performed at no additional charge. Includes quantification of Clostridium perfringens enterotoxin (CPA and CPE) genes if PCR positive. Note: The reflex culture will only be performed if a specimen in fecal culture transport media is received. Diarrhea RealPCR Panel (Comprehensive Plus) Feline 3258 $ Campylobacter coli, Campylobacter jejuni, Clostridium perfringens alpha toxin (CPA) gene Quant, Clostridium perfringens enterotoxin (CPE) gene Quant, Cryptosporidium spp., feline coronavirus (FCoV), feline panleukopenia virus, Giardia spp., Salmonella spp., Toxoplasma gondii and Tritrichomonas foetus RealPCR tests. If the RealPCR test is positive for Campylobacter spp. or Salmonella spp., a culture on selective media (with susceptibilities for Salmonella) will be automatically performed at no additional charge. Includes quantification of Clostridium perfringens enterotoxin (CPA and CPE) genes if PCR positive. Note: The reflex culture will only be performed if a specimen in fecal culture transport media is received. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. IDEXX RealPCR Directory 7

10 Canine and Feline RealPCR Tests Gastrointestinal Disease Diarrhea RealPCR Panel (Comprehensive) Canine 2625 $ Add-on to fecal ova and parasites or fecal culture $99.00 Save 40% until December 31, 2014 $59.29 Campylobacter coli, Campylobacter jejuni, canine circovirus, canine distemper virus (CDV), canine enteric coronavirus (CECoV), canine parvovirus 2 (CPV-2), Clostridium perfringens alpha toxin (CPA) gene, Cryptosporidium spp., Giardia spp. and Salmonella spp. RealPCR tests. If the RealPCR test is positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Note: The reflex culture will only be performed if a specimen in fecal culture transport media is received. Diarrhea RealPCR Panel (Comprehensive) Feline 2627 $ Add-on to fecal ova and parasites or fecal culture $ Save 40% until December 31, 2014 $61.09 Campylobacter coli, Campylobacter jejuni, Clostridium perfringens alpha toxin (CPA) gene, Cryptosporidium spp., feline coronavirus (FCoV), feline panleukopenia virus, Giardia spp., Salmonella spp., Toxoplasma gondii and Tritrichomonas foetus RealPCR tests. If the RealPCR test is positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Note: The reflex culture will only be performed if a specimen in fecal culture transport media is received. Diarrhea RealPCR Panel (Standard) Canine 3270 $74.59 Campylobacter coli, Campylobacter jejuni, Cryptosporidium spp., Giardia spp. and Salmonella spp. RealPCR tests. If the RealPCR test is positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Note: The reflex culture will only be performed if a specimen in fecal culture transport media is received. Diarrhea RealPCR Panel (Standard) Feline 2626 $88.79 Cryptosporidium spp., Giardia spp. and Tritrichomonas foetus RealPCR tests Campylobacter coli RealPCR Test 3267 $48.26 Add-on $42.62 Campylobacter jejuni RealPCR Test 3266 $48.26 Add-on $42.62 Canine Enteric Coronavirus (CECoV) RealPCR Test 2648 $61.91 NEW Circovirus RealPCR Test Canine 3571 $48.29 Clostridium perfringens Alpha Toxin (CPA) Gene RealPCR Test 2646 $48.26 Clostridium perfringens Alpha Toxin (CPA) Gene Quant RealPCR Test 3646 $57.59 Add-on to fecal ova and parasites, fecal culture or fecal RealPCR test $53.59 Includes quantification of Clostridium perfringens alpha toxin (CPA) gene if PCR positive. Clostridium perfringens Enterotoxin (CPE) Gene Quant RealPCR Test 3268 $57.59 Add-on to fecal ova and parasites, fecal culture or fecal RealPCR test $53.59 Includes quantification of Clostridium perfringens enterotoxin (CPE) gene if PCR positive. Clostridium perfringens Enterotoxin (CPE and CPA) Genes Quant 3269 $82.59 RealPCR Panel Add-on to fecal ova and parasites, fecal culture or fecal RealPCR test $78.59 Clostridium perfringens enterotoxin (CPE) gene Quant and Clostridium perfringens alpha toxin (CPA) gene Quant RealPCR tests. Includes quantification of Clostridium perfringens enterotoxin (CPE and CPA) genes if PCR positive. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 8 IDEXX RealPCR Directory

11 Canine and Feline RealPCR Tests Gastrointestinal Disease Cryptosporidium spp. RealPCR Test 2630 $48.26 Distemper Virus (CDV) RealPCR Test Canine 2265 $61.79 Ideal specimen depends on clinical manifestation. See distemper virus listing on page 25 for specimen requirements for other clinical manifestations. For GI manifestations: 2 ml EDTA whole blood (LTT) and 5 g (1 g minimum) fresh feces in a sterile container; keep refrigerated. Feline Coronavirus (FCoV) RealPCR Test 1714 $61.79 Ideal specimen depends on clinical manifestation. See feline coronavirus listing on page 25 for specimen requirements for other clinical manifestations. Feline Panleukopenia Virus RealPCR Test 2655 $48.26 Giardia spp. RealPCR Test 2631 $48.26 Parvovirus 2 (CPV-2) RealPCR Test Canine 2649 $48.29 Rotavirus RealPCR Test 3282 $61.79 Salmonella spp. RealPCR Test 2647 $48.26 If the RealPCR test is positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Note: The reflex culture will only be performed if a sample in fecal culture transport media is received. Toxoplasma gondii RealPCR Test 2654 $48.26 Ideal specimen depends on clinical manifestation. 5 g fresh feces (1 g minimum) in a sterile container, 2 ml EDTA whole blood or 0.5 ml (0.1 ml minimum) CSF; keep refrigerated. Collect sample prior to antibiotic administration. Tritrichomonas foetus RealPCR Test 2629 $48.29 Canine circovirus: an emerging pathogen Canine circovirus is a newly recognized pathogen that has been implicated in cases of hemorrhagic gastroenteritis, necrotizing vasculitis and granulomatous lymphadenitis. The new Canine Circovirus RealPCR Test was added to all canine diarrhea RealPCR panels in December In the first two months of testing, canine circovirus was identified in 8.3% of diarrhea RealPCR panel submissions in the United States (see map for locations of positive specimens). Canine circovirus is commonly found as a coinfection with other pathogens (69.3% of all circovirus positive results) and is suspected to be a complicating factor for infections with other canine gastrointestinal pathogens. Locations of positive Canine Circovirus RealPCR Test results (n=79; December 2013 January 2014) Source: Data on file at IDEXX Laboratories, Inc. Westbrook, Maine USA. IDEXX RealPCR Directory 9

12 Canine and Feline RealPCR Tests Kidney/Liver Disease Leptospirosis is a zoonotic disease of worldwide significance that most commonly causes acute kidney disease in dogs with or without evidence of hepatitis, but other clinical manifestations of disease are becoming increasingly recognized. The diagnostic advantage of PCR over serology occurs during the very early stages of the infection prior to the development of antibodies in most dogs and for the detection of urinary shedding in sick and healthy animals. PCR on blood specimens will be positive very early in infection, usually prior to seroconversion. Urine will become positive by PCR 7 14 days after infection, at which time, leptospires may or may not be detected in the blood. In a study of dogs experimentally infected with Leptospira pomona, the highest diagnostic sensitivity (92%) was seen when testing was performed on both urine and blood. 1 Leptospira spp. RealPCR Test performance: Validation of the Leptospira spp. RealPCR Test using combined blood and urine specimens from confirmed positive experimentally infected dogs and confirmed negative urine specimens. IDEXX RealPCR Experimental Infection Pos Neg Pos 24 1 Neg Performance Sensitivity 92% Specificity 99% PPV 96% NPV 99% Consider testing dogs with: Acute kidney disease, unless known toxin exposure or pyelonephritis is definitively diagnosed Polyuria and polydipsia (PU/PD) without azotemia Hepatic failure, hepatitis Fever, vasculitis, uveitis, coagulopathies, acute respiratory distress Chronic kidney disease of unknown etiology Also consider testing dogs that could be shedding leptospires in their urine, including: Dogs after treatment; previously tested positive by PCR or MAT Dogs in the same household/environment as an infected dog High-risk dogs (e.g., hunting dogs, dogs in contact with stagnant water) Leptospira spp. Panel Canine 3569 $49.95 Leptospira spp. RealPCR Test, Leptospira spp. antibody by ELISA 2 ml EDTA whole blood (LTT) and 2 ml urine in a sterile container for RealPCR tests (keep refrigerated) and 1 ml serum for serology. Collect specimens prior to antibiotic administration. Leptospira spp. RealPCR Test 2628 $39.95 Detects pathogenic strains only. 2 ml EDTA whole blood (LTT) and 2 ml urine in a sterile container; keep refrigerated. Collect specimens prior to antibiotic administration. Reference: 1. leutenegger CM, Palaniappan R, Elsemore D, Estrada M, Thao M, Cornwell D. Analytical Sensitivity and Specificity of a Real-Time PCR Assay Detecting Pathogenic Leptospira in Dogs Based on the hap1 Gene. Poster presented at: 2009 ACVIM Forum; June 2 6, 2009; Montreal, Canada. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 10 IDEXX RealPCR Directory

13 Canine and Feline RealPCR Tests Neurologic Disease Infectious causes of neurologic disease in dogs and cats can be difficult to diagnose. Performing RealPCR testing on cerebral spinal fluid (preferred) and sometimes on blood provides you with another tool to assist in identifying neurologic pathogens. Indications include: The presence of intracranial disease manifestations including: Depression, change in behavior Seizures Ataxia, circling, vestibular disease Cortical blindness Paresis, paralysis Finding abnormalities on CSF analysis, including elevated cell count and/or elevated protein The presence of unexplained neck pain Neurologic disease specimen requirements unless indicated otherwise: 0.5 ml (0.1 ml minimum) CSF (preferred) and/or 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. Neurologic RealPCR Panel with FeLV/FIV by ELISA Feline 3033 $98.90 Bartonella spp., Cryptococcus spp., feline coronavirus (FCoV), FeLV, FIV and Toxoplasma gondii RealPCR tests, FeLV antigen and FIV antibody by ELISA 1 ml serum for ELISAs and 0.5 ml (0.1 ml minimum) CSF for RealPCR tests; keep refrigerated Neurologic RealPCR Panel with Lyme Quant C 6 Test Canine 3031 $ Bartonella spp, Borrelia burgdorferi, Blastomyces dermatitidis, canine distemper virus (CDV), Coccidioides spp., Cryptococcus spp., Histoplasma capsulatum, Neospora spp., Toxoplasma gondii and West Nile virus RealPCR tests, Lyme Quant C 6 Test 1 ml serum for Lyme Quant C 6 Test and 0.5 ml (0.1 ml minimum) CSF for RealPCR tests; keep refrigerated Bartonella spp. RealPCR Test Feline 2267 $48.29 Distemper Virus (CDV) RealPCR Test Canine 2265 $61.79 Ideal specimen depends on clinical manifestation. See distemper virus listing on page 25 for specimen requirements for other clinical manifestations. For neurological manifestations: 2 ml EDTA whole blood (LTT), 0.5 ml (0.1 ml minimum) CSF and a conjunctival swab (preferred); or 2 ml EDTA whole blood (LTT), 2 ml urine and a conjunctival swab. For conjunctival swab, wipe eye clean and swab inside of eyelid. Please submit dry, plastic-stemmed swab, without transport media, in an RTT or an empty, sterile tube. Feline Coronavirus (FCoV) RealPCR Test 1714 $61.79 Ideal specimen depends on clinical manifestation. See feline coronavirus listing on page 25 for specimen requirements for other clinical manifestations. FeLV RealPCR Test 2635 $48.29 Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV infections. FIV RealPCR Test 2866 $61.79 FIV subtype A, B, C, D and F RealPCR tests Neospora spp. RealPCR Test 3028 $48.26 Toxoplasma gondii RealPCR Test 2654 $48.26 West Nile Virus RealPCR Test 3030 $61.91 IDEXX RealPCR Directory 11

14 Canine and Feline RealPCR Tests Reproductive Disease Embyronic loss, resorption, abortion or fetal retention can be devastating to any breeding program and may be caused by infectious or noninfectious etiologies. Loss of a litter due to an infectious etiology raises additional concerns, such as risks of contagion to other valuable breeding animals and, in some cases, zoonotic potential. Complete evaluation for infectious causes of canine and feline abortion has historically been complex, requiring the submission of multiple individual test components. With the advent of the Abortion RealPCR Panel, it is now possible to test for the major infectious causes of abortion with a cost-effective, single-testing package combining a sensitive diagnostic tool with a short turnaround time. With the options to include aerobic culture and histopathology, the canine and feline abortion panels may be expanded to compliment RealPCR testing and increase the diagnostic yield. Note: When available, the placenta should be considered the gold standard in terms of specimen type, as most infectious agents will be detected in the placenta. The addition of placenta and fetal liver specimens for histopathology and aerobic culture greatly facilitate a comprehensive case evaluation. Reproductive disease specimen requirements unless indicated otherwise: Fresh placental tissue (preferred); fresh fetal spleen, liver and kidney; and 2 ml fetal stomach contents and/or 2 ml EDTA whole blood (LTT) from bitch. Submit tissue, fluids and dry, plastic-stemmed swabs, without transport media, in RTTs or empty, sterile containers. Collect specimens prior to antibiotic administration; keep refrigerated. When ordering a panel that includes a culture, also submit fresh placental tissue and fresh fetal liver +/ lung (pooled) in a sterile container or a Culturette. When ordering a panel that includes a biopsy, also submit specimens in 10% formalin. Recommended sites for biopsies in order of priority are placenta, fetal liver, fetal lung, fetal kidney, maternal uterus, fetal heart, fetal brain. ; allow additional time for culture if indicated NEW Abortion Profile (Comprehensive) Canine 3554 $ Abortion RealPCR Panel Canine, Streptococcus canis, Streptococcus dysgalactiae subsp. equisimilis and Streptococcus equi subsp. zooepidemicus RealPCR tests, aerobic culture with susceptibilities, biopsy with microscopic description (up to 5 sites). Note: Recommended sites for biopsies in order of priority are placenta, fetal liver, fetal lung, maternal uterus, fetal heart, fetal brain. NEW Abortion Profile (Comprehensive) Feline 3557 $ Abortion RealPCR Panel Feline, Streptococcus canis, Streptococcus dysgalactiae subsp. equisimilis, and Streptococcus equi subsp. zooepidemicus RealPCR tests, aerobic culture with susceptibilities, biopsy with microscopic description (up to 5 sites). Note: Recommended sites for biopsies in order of priority are placenta, fetal liver, fetal lung, maternal uterus, fetal heart, fetal brain. NEW Abortion RealPCR Panel Canine 3552 $77.50 Brucella canis, Campylobacter jejuni, canine distemper virus (CDV), canine herpesvirus type 1 (CHV-1), Leptospira spp., minute virus (parvovirus type 1), Leishmania spp., Neospora caninum, Salmonella spp. and Toxoplasma gondii RealPCR tests Note: Culture and placental biopsy are recommended in addition to the RealPCR panel (see Abortion RealPCR Panel with Culture Canine [Test Code 3553] and Abortion Profile [Comprehensive] Canine [Test Code 3554]) See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 12 IDEXX RealPCR Directory

15 Canine and Feline RealPCR Tests Reproductive Disease NEW Abortion RealPCR Panel Feline 3555 $68.00 Chlamydophila felis, feline coronavirus (FCoV), feline herpesvirus type 1 (FHV-1), feline panleukopenia virus, FeLV, FIV, Leptospira spp. and Toxoplasma gondii RealPCR tests. Note: Culture and placental biopsy are recommended in addition to the RealPCR panel (see Abortion RealPCR Panel with Culture Feline [Test Code 3556] and Abortion Profile [Comprehensive] Feline [Test Code 3557]) NEW Abortion RealPCR Panel with Culture Canine 3553 $94.50 Abortion RealPCR Panel Canine, aerobic culture with susceptibilities NEW Abortion RealPCR Panel with Culture Feline 3556 $85.00 Abortion RealPCR Panel Feline, aerobic culture with susceptibilities Brucella canis RealPCR Test 2865 $48.29 Campylobacter jejuni RealPCR Test 3266 $48.26 Canine Herpesvirus Type 1 (CHV-1) RealPCR Test 2520 $48.26 Chlamydophila felis RealPCR Test 2513 $48.26 Distemper Virus (CDV) RealPCR Test Canine 2265 $61.79 Ideal specimen depends on clinical manifestation. See distemper virus listing on page 25 for specimen requirements for other clinical manifestations. Feline Coronavirus RealPCR Test 1714 $61.79 Ideal specimen depends on clinical manifestation. See feline coronavirus listing on page 25 for specimen requirements for other clinical manifestations. Feline Panleukopenia Virus RealPCR Test 2655 $48.26 FeLV RealPCR Test 2635 $48.29 FIV RealPCR Test 2866 $61.79 FIV subtype A, B, C, D and F RealPCR tests Leishmania spp. RealPCR Test 2834 $48.26 Leptospira spp. RealPCR Test 2628 $39.95 Neospora spp. RealPCR Test 3028 $48.26 Salmonella spp. RealPCR Test 2647 $48.26 Streptococcus spp. Abortion RealPCR Panel 3577 $63.09 Streptococcus canis, Streptococcus dysgalactiae subsp. equisimilis and Streptococcus equi subsp. zooepidemicus RealPCR tests Note: Culture and placental biopsy are recommended in addition to the RealPCR panel (see Abortion Profile [Comprehensive] Canine [Test Code 3554] and Abortion Profile [Comprehensive] Feline [Test Code 3557]). Toxoplasma gondii RealPCR Test 2654 $48.26 IDEXX RealPCR Directory 13

16 Canine and Feline RealPCR Tests Respiratory Disease Identify the most common infectious causes of respiratory disease and recognize coinfections. Our canine respiratory panels now include canine pneumovirus. This recently recognized pathogen is associated with mixed-respiratory signs of varying severity. Indications for testing puppies and adult dogs include: Clinical signs of respiratory disease or kennel cough (nasal discharge, conjunctivitis, fever and/or dry hacking cough), especially if there is a recent history of being kenneled, hospitalized or exposed to other dogs Indications for testing kittens and adult cats include: Persistent or recurrent signs of upper respiratory disease (URD), including sneezing, oculonasal discharge, inappetence, fever and oral ulceration Persistent or recurrent conjunctivitis or more severe ocular disease Chronic rhinitis/sniffles Indications for testing in shelters include: Documentation of background levels of respiratory pathogens Provide guidance on vaccination and treatment protocols Identification of cause and management of respiratory disease outbreak Respiratory disease specimen requirements unless indicated otherwise: Deep pharyngeal swab (with visible organic material on swab; please rub firmly) and a conjunctival swab (wipe eye clean; swab inside of eyelid) in the same tube. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. When acquiring a pharyngeal swab, precautions should be taken to prevent patient from biting and/or ingesting part of swab. Collect specimens prior to antibiotic administration. When ordering a panel that includes a culture if indicated, also submit an additional BD Culturette (culture swab in transport media). NEW Canine Lungworm RealPCR Panel 3545 $57.29 Angiostrongylus vasorum (French heartworm) and Crenosoma vulpis (fox lungworm) RealPCR tests 5 g (1 g minimum) fresh feces, 2 ml (0.1 ml minimum) tracheal wash fluid, or 2 ml EDTA whole blood (LTT); keep refrigerated NEW Feline Conjunctivitis RealPCR Panel 3551 $52.45 Chlamydophila felis, feline calicivirus, feline herpesvirus type 1 (FHV-1) Quant and Mycoplasma felis RealPCR tests. Includes quantification of feline herpesvirus type 1 (FHV-1) viral particles if PCR positive. Respiratory Disease (CRD) RealPCR Panel (Comprehensive) Canine 2524 $91.59 Bordetella bronchiseptica, canine adenovirus type 2, canine distemper virus (CDV) Quant, canine herpesvirus type 1 (CHV-1), canine influenza virus (H3N8), canine parainfluenza virus, canine pneumovirus, canine respiratory coronavirus (CRCoV), H1N1 pandemic influenza virus, Mycoplasma cynos and Streptococcus equi subsp. zooepidemicus RealPCR tests. Includes quantification of distemper viral particles if PCR positive. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 14 IDEXX RealPCR Directory

17 Canine and Feline RealPCR Tests Respiratory Disease Respiratory Disease (CRD) RealPCR Panel (Comprehensive) with Culture (if Indicated) Canine Bordetella bronchiseptica, canine adenovirus type 2, canine distemper virus (CDV) Quant, canine herpesvirus type 1 (CHV-1), canine influenza virus (H3N8), canine parainfluenza virus, canine pneumovirus, canine respiratory coronavirus (CRCoV), H1N1 pandemic influenza virus, Mycoplasma cynos and Streptococcus equi subsp. zooepidemicus RealPCR tests. If the RealPCR test is positive for Bordetella bronchiseptica or Streptococcus equi subsp. zooepidemicus, a culture with susceptibilities on selective media will be automatically performed at no additional charge. Includes quantification of distemper viral particles if PCR positive. Note: Culture will only be performed if an additional Culturette (culture swab in transport media) is submitted $ NEW Respiratory Disease (CRD) RealPCR Panel (Standard) Canine 3547 $69.45 Bordetella bronchiseptica, canine adenovirus type 2, canine distemper virus (CDV) Quant, canine parainfluenza virus, canine respiratory coronavirus (CRCoV), canine pneumovirus and Mycoplasma cynos RealPCR tests. Includes quantification of distemper viral particles if PCR positive. Upper Respiratory Disease (URD) RealPCR Panel Feline 2512 $82.90 Bordetella bronchiseptica, Chlamydophila felis, feline calicivirus, feline herpesvirus type 1 (FHV-1) Quant, H1N1 pandemic influenza virus and Mycoplasma felis RealPCR tests. Includes quantification of feline herpesvirus type 1 (FHV-1) viral particles if PCR positive. Upper Respiratory Disease (URD) RealPCR Panel 3037 $ with Culture (if Indicated) Feline Bordetella bronchiseptica, Chlamydophila felis, feline calicivirus, feline herpesvirus 1 (FHV-1) Quant, H1N1 pandemic influenza virus and Mycoplasma felis RealPCR tests. If the RealPCR test is positive for Bordetella bronchiseptica, a culture with susceptibilities on selective media for Bordetella will be automatically performed at no additional charge. Includes quantification of feline herpesvirus type 1 (FHV-1) viral particles if PCR positive. Note: Culture will only be performed if an additional Culturette (culture swab in transport media) is submitted. Bordetella bronchiseptica RealPCR Test Canine 2518 $48.26 Bordetella bronchiseptica RealPCR Test Feline 2516 $48.26 Canine Adenovirus Type 2 RealPCR Test 2519 $48.26 Canine Herpesvirus Type 1 (CHV-1) RealPCR Test 2520 $48.26 Canine Influenza Virus (H3N8) RealPCR Test 2522 $61.79 Canine Parainfluenza Virus RealPCR Test 2521 $61.91 NEW Canine Pneumovirus RealPCR Test 3546 $48.29 Canine Respiratory Coronavirus (CRCoV) RealPCR Test 2523 $61.91 Chlamydophila felis RealPCR Test 2513 $48.26 Distemper Virus (CDV) RealPCR Test Canine 2265 $61.79 Ideal specimen depends on clinical manifestation. See distemper virus listing on page 25 for specimen requirements for other clinical manifestations. IDEXX RealPCR Directory 15

18 Canine and Feline RealPCR Tests Respiratory Disease Distemper Virus (CDV) Quant RealPCR Test Canine 3265 $71.00 Add-on $67.00 Includes quantification of distemper viral particles if PCR positive. Note: Use for dogs with respiratory signs consistent with canine distemper virus that have been vaccinated with a modified live vaccine within the previous 4 weeks or for whom a quantitative value is required. For dogs with clinical manifestations requiring other nonrespiratory specimen types or in dogs for which vaccine interference is not a concern, please see Distemper Virus (CDV) RealPCR Test Canine (Test Code 2265). The Distemper Virus (CDV) Quant RealPCR Test can only be performed on swabs from respiratory mucosal surfaces. Feline Calicivirus RealPCR Test 2514 $61.91 Feline Herpesvirus Type 1 (FHV-1) Quant RealPCR Test 2515 $48.26 Includes quantification of feline herpesvirus type 1 (FHV-1) viral particles if PCR positive. H1N1 Pandemic Influenza Virus RealPCR Test 2927 $61.79 Mycoplasma cynos RealPCR Test Canine 3087 $48.26 Mycoplasma felis RealPCR Test 2517 $48.26 Streptococcus equi subsp. zooepidemicus RealPCR Test Canine 3092 $48.26 See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 16 IDEXX RealPCR Directory

19 Canine and Feline RealPCR Tests Systemic Mycoses Systemic mycoses are associated with high morbidity and mortality especially if undiagnosed and untreated. Because of the length of time, difficulty and zoonotic potential associated with culture, diagnosis has until now relied on serology and/or microscopic identification of the fungus on tissue biopsies or cytologic samples. The Systemic Mycoses RealPCR Panel provides a sensitive diagnostic tool to detect these infectious fungal pathogens. Consider testing dogs or cats with: Nonspecific clinical signs, such as fever, lethargy, anorexia, weight loss, lymphadenopathy Respiratory signs, including dyspnea, coughing, nasal mass or discharge, sneezing, epistaxis Ocular signs, including uveitis, chorioretinitis, keratitis, panophthalmitis, acute blindness, exophthalmos Neurological signs, including depression, seizures, ataxia, behavioral changes GI signs, including large and/or small bowel diarrhea with protein-losing enteropathy Musculoskeletal signs, including lameness, bone pain Systemic mycoses specimen requirements: Ideal specimen depends on clinical manifestation. Keep all specimens refrigerated. Collect specimens prior to antifungal administration. For respiratory manifestations: Deep pharyngeal swab (with visible organic material on swab; please rub firmly) and/or nasal swab. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Multiple swabs can be submitted together in the same tube. When acquiring a pharyngeal swab, precautions should be taken to prevent patient from biting and/or ingesting part of swab. 0.5 ml (0.1 ml minimum) tracheal wash or bronchoalveolar lavage fluid. Aspirate* or biopsy* of nasal mass. For ocular manifestations: 0.5 ml (0.1 ml minimum) uveal fluid, ocular tissue aspirate* or biopsy.* For neurological manifestations: 0.5 ml (0.1 ml minimum) CSF. For GI manifestations: 5 g (1 g minimum) fresh feces in a sterile container. For skin lesions: Tissue aspirate,* 0.5 ml (0.1 ml minimum) fluid, if available, or biopsy.* For bone lesions: Bone aspirate* or biopsy.* For systemic, nonspecific manifestations: 2 ml EDTA whole blood (LTT). Systemic Mycoses RealPCR Panel 3104 $71.90 Blastomyces dermatitidis, Coccidioides spp., Cryptococcus spp. and Histoplasma capsulatum RealPCR tests Blastomyces dermatitidis RealPCR Test 3024 $48.26 Coccidioides spp. RealPCR Test 3025 $48.26 Cryptococcus spp. RealPCR Test 3026 $48.26 Histoplasma capsulatum RealPCR Test 3027 $48.26 * see RealPCR Specimen Collection Guidelines (page 5) for detailed protocols for submission of tissue aspirates or biopsies. IDEXX RealPCR Directory 17

20 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia In patients with infectious causes of anemia or vector-borne disease, coinfections are common. Identify the common infectious causes of anemia and vector-borne disease quickly, accurately and affordably by choosing from IDEXX s comprehensive test menu. Many of the tick/vector-borne disease and anemia RealPCR panels listed below include serologic testing for specific pathogens to provide you with the most complete and accurate diagnostic information for your patient. Benefits and limitations of serology vs PCR testing for diagnosis of tick/vector-borne diseases: Serology Useful for screening and aiding in diagnosis of infection Clinical signs may precede a measurable antibody response Polymerase chain reaction (PCR) Measures Antibody response of host Nucleic acid (DNA) from pathogen Benefits Specifically identifies pathogens indicating active infection Limitations A negative PCR result does not necessarily rule out infection Dogs with ehrlichiosis or anaplasmosis may present with clinical signs at different times after infection. Which sick dog are you dealing with? Using serology and PCR together improves your ability to make a complete and accurate diagnosis. Positive result PCR Serology Time postinfection Infection or Recrudescence Dog A presents Dog B presents Dog C presents Indications for testing include identifying infectious causes of: Anemia Thrombocytopenia, neutropenia Lethargy, fever, lymphadenopathy Lameness, evidence of polyarthritis Proteinuria Bleeding disorders resulting in epistaxis, petechia, ecchymoses Uveitis, neurological signs Tick/Vector-borne disease and anemia specimen requirements unless indicated otherwise: 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. When ordering a panel that includes a Lab 4Dx Plus Test*, Lyme Quant C 6 Test or FeLV antigen and FIV antibody by ELISA, also submit 1 ml serum. * The Lab 4Dx Plus Test includes ELISAs for heartworm antigen and Ehrlichia canis, Ehrlichia ewingii, Anaplasma phagocytophilum, Anaplasma platys and Lyme C 6 antibodies. 18 IDEXX RealPCR Directory

21 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia Components of the Tick/Vector-borne Disease and Anemia RealPCR Panels Anemia RealPCR Panel with FeLV/FIV by ELISA Feline Anemia RealPCR Panel Canine Anemia RealPCR Panel with Lab 4Dx Plus Test Canine Tick RealPCR Panel 4 with Lab 4Dx Plus Test and Reflex Lyme Quant C6 Test (if indicated) Tick RealPCR Panel 4 with Lyme Quant C6 Test Tick RealPCR Panel with Lab 4Dx Plus Test Tick RealPCR Panel with Lyme Quant C6 Test Test Code RealPCR tests Anaplasma spp. Babesia spp. Bartonella spp. Borrelia burgdorferi Canine Hemotropic Mycoplasma Cytauxzoon felis Ehrlichia spp. Feline Hemotropic Mycoplasma FeLV FIV Hepatozoon spp. Leishmania spp. Leptospira spp. Neorickettsia risticii Rocky Mountain Spotted Fever Serology FeLV Antigen FIV Antibody Lab 4Dx Plus Test Lyme Quant C 6 Test Reflex Lyme Quant C 6 Test IDEXX RealPCR Directory 19

22 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia Components of the Tick/Vector-borne Disease and Anemia RealPCR Panels Tick/Vector Comprehensive RealPCR Panel Canine Tick/Vector Comprehensive RealPCR Panel with Lab 4Dx Plus Test Canine Tick/Vector Comprehensive RealPCR Panel with Lab 4Dx Plus Test and Reflex Lyme Quant C6 Test (if Indicated) Canine Tick/Vector Comprehensive RealPCR Panel with Lyme Quant C6 Test Canine Tick/Vector RealPCR Panel Feline Tick/Vector RealPCR Panel (Tick Analysis) Test Code RealPCR tests Anaplasma spp. Babesia spp. Bartonella spp. Borrelia burgdorferi Canine Hemotropic Mycoplasma Cytauxzoon felis Ehrlichia spp. Feline Hemotropic Mycoplasma FeLV FIV Hepatozoon spp. Leishmania spp. Leptospira spp. Neorickettsia risticii Rocky Mountain Spotted Fever Serology FeLV Antigen FIV Antibody Lab 4Dx Plus Test Lyme Quant C 6 Test Reflex Lyme Quant C 6 Test See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 20 IDEXX RealPCR Directory

23 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia Anemia RealPCR Panel Canine 2938 $83.29 Anaplasma spp., Babesia spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leptospira spp. and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests NEW Anemia RealPCR Panel Feline 3572 $81.90 Anaplasma spp., Bartonella spp., Cytauxzoon felis, Ehrlichia spp., Feline Hemotropic Mycoplasma (FHM), FeLV and FIV RealPCR tests Anemia RealPCR Panel with FeLV/FIV by ELISA Feline 2906 $99.90 Anaplasma spp., Bartonella spp., Cytauxzoon felis, Ehrlichia spp., Feline Hemotropic Mycoplasma, FeLV and FIV RealPCR tests, FeLV antigen and FIV antibody by ELISA Anemia RealPCR Panel with Lab 4Dx Plus Test Canine* 2907 $94.90 Anaplasma spp., Babesia spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leptospira spp. and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lab 4Dx Plus Test Tick/Vector Comprehensive RealPCR Panel Canine 2870 $83.29 Anaplasma spp., Babesia spp., Bartonella spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leishmania spp. Quant, Neorickettsia risticii and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests. Includes quantification of Leishmania if PCR positive. Tick/Vector Comprehensive RealPCR Panel with Lab 4Dx Plus Test 2902 $ and Reflex Lyme Quant C 6 Test (if Indicated) Canine* Anaplasma spp., Babesia spp., Bartonella spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leishmania spp. Quant, Neorickettsia risticii and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lab 4Dx Plus Test. If the Lab 4Dx Plus Test is positive for Lyme, a Lyme Quant C 6 Test is automatically run at no additional charge. Includes quantification of Leishmania if PCR positive. Tick/Vector Comprehensive RealPCR Panel with Lab 4Dx Plus Test Canine* 2871 $95.59 Anaplasma spp., Babesia spp., Bartonella spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leishmania spp. Quant, Neorickettsia risticii and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lab 4Dx Plus Test. Includes quantification of Leishmania if PCR positive. Tick/Vector Comprehensive RealPCR Panel 2828 $ with Lyme Quant C 6 Test Canine Anaplasma spp., Babesia spp., Bartonella spp., Canine Hemotropic Mycoplasma, Ehrlichia spp., Hepatozoon spp., Leishmania spp. Quant, Neorickettsia risticii and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lyme Quant C 6 Test. Includes quantification of Leishmania if PCR positive. Tick/Vector RealPCR Panel Feline 2827 $71.90 Anaplasma spp., Bartonella spp., Cytauxzoon felis, Ehrlichia spp. and Feline Hemotropic Mycoplasma (FHM) RealPCR tests Tick/Vector RealPCR Panel (Tick Analysis) 3396 $99.29 Anaplasma spp., Babesia spp., Bartonella spp., Borrelia burgdorferi, Canine Hemotropic Mycoplasma, Cytauxzoon felis, Ehrlichia spp., Hepatozoon spp., Leishmania spp., Neorickettsia risticii and Rickettsia spp. (includes Rocky Mountain spotted fever [Rickettsia risticii]) RealPCR tests Tick in sterile container (no formalin); keep refrigerated Tick RealPCR Panel 4 with Lab 4Dx Plus Test and Reflex Lyme Quant C 6 Test (if indicated)* 2901 $82.59 Anaplasma spp. and Ehrlichia spp. RealPCR tests, Lab 4Dx Plus Test. If the Lab 4Dx Plus Test is positive for Lyme, a Lyme Quant C 6 Test is automatically run at no additional charge. Tick RealPCR Panel 4 with Lab 4Dx Plus Test* 2821 $69.19 Anaplasma spp. and Ehrlichia spp. RealPCR tests, Lab 4Dx Plus Test *Recommended panels if you HAVE NOT performed a SNAP 3Dx or SNAP 4Dx Plus Test on your canine patient. Recommended panels if you HAVE performed a SNAP 3Dx or SNAP 4Dx Plus Test on your canine patient. IDEXX RealPCR Directory 21

24 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia Tick RealPCR Panel 4 with Lyme Quant C 6 Test 2822 $77.29 Anaplasma spp. and Ehrlichia spp. RealPCR tests, Lyme Quant C 6 Test Tick RealPCR Panel with Lab 4Dx Plus Test* 2823 $75.09 Anaplasma spp., Ehrlichia spp. and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lab 4Dx Plus Test Tick RealPCR Panel with Lyme Quant C 6 Test 2826 $83.29 Anaplasma spp., Ehrlichia spp. and Rocky Mountain spotted fever (Rickettsia risticii) RealPCR tests, Lyme Quant C 6 Test Anaplasma spp. RealPCR Test 2824 $48.29 Anaplasma phagocytophilum and Anaplasma platys RealPCR tests Babesia spp. RealPCR Test 2633 $48.29 Babesia canis canis, Babesia canis rossi, Babesia canis vogeli, Babesia conradae, Babesia felis and Babesia gibsoni RealPCR tests Bartonella spp. RealPCR Test Feline 2267 $48.29 Borrelia spp. RealPCR Test 2855 $48.26 Tick in sterile container, 0.5 ml (0.1 ml minimum) CSF or skin/joint biopsies; keep refrigerated. Canine Hemotropic Mycoplasma RealPCR Test 2632 $48.26 Mycoplasma haemocanis and Candidatus Mycoplasma haematoparvum RealPCR tests Cytauxzoon felis RealPCR Test 2636 $48.26 Ehrlichia spp. RealPCR Test 2854 $48.29 Ehrlichia canis, Ehrlichia chaffeensis and Ehrlichia ewingii RealPCR tests Feline Hemotropic Mycoplasma (FHM) RealPCR Test 1717 $48.29 Add-on $ Mycoplasma haemofelis (formerly Haemobartonella felis), Candidatus Mycoplasma haemominutum and Candidatus Mycoplasma turicensis RealPCR tests Feline Hemotropic Mycoplasma (FHM) RealPCR Test if Anemic $26.83 Test must accompany a CBC or a profile that includes a CBC. The Feline Hemotropic Mycoplasma (FHM) RealPCR Test will be run only if the cat s Hct is 28%. You will only be charged for a Feline Hemotropic Mycoplasma (FHM) RealPCR Test if the test is run. FeLV RealPCR Test 2635 $48.29 Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV infections. FIV RealPCR Test 2866 $61.79 FIV subtype A, B, C, D and F RealPCR tests FeLV and FIV RealPCR Panel 3356 $70.95 Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV and FIV infections. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 22 IDEXX RealPCR Directory

25 Canine and Feline RealPCR Tests Tick/Vector-borne Disease and Anemia Hepatozoon spp. RealPCR Test 2833 $48.26 Hepatozoon canis and Hepatozoon americanum RealPCR tests NEW Leishmania spp. Quant RealPCR Test (Blood) 3570 $58.29 Includes quantification of Leishmania if PCR positive. NEW Leishmania spp. Quant RealPCR Test (Bone Marrow) 3583 $58.29 Includes quantification of Leishmania if PCR positive. 2 ml (0.1 ml minimum) bone marrow aspirate in EDTA (LTT) or 1 3 unstained air-dried slides Leishmania spp. RealPCR Test 2834 $48.26 Neorickettsia risticii RealPCR Test 2829 $48.26 Rocky Mountain Spotted Fever (Rickettsia risticii) RealPCR Test 2825 $48.29 Feline Hemotropic Mycoplasma: IDEXX RealPCR Testing vs. Microscopic Slide Review 2 Total specimens = 303 Positives found by IDEXX RealPCR testing Positives found by slide review Positive for any species 88 (29.0%) 10 (3.3%) Positives by species or species combination Mhf 21 (6.9%) CaMh 41 (13.5%) CaMt 5 (1.7%) Mhf & CaMh 8 (2.6%) Mhf & CaMt 3 (1.0%) CaMh & CaMt 3 (1.0%) Mhf & CaMh & CaMt 7 (2.3%) Could not distinguish species Mhf = Mycoplasma haemofelis CaMh = Candidatus Mycoplasma haemominutum CaMt = Candidatus Mycoplasma turicensis Note: Data provided above from IDEXX internal study of whole blood specimens from cats with hematocrit less than 25%. Data on file at IDEXX Laboratories, Inc., Westbrook, Maine USA. Reference: 2. leutenegger CM, Robertson J, Estrada M, Thao M, Cornwell D. Association of Pathogenicity and Rate of Coinfection of Three Feline Hemotropic Mycoplasma Strains with Presence and Severity of Anemia. Poster presented at: 2009 ACVIM Forum; June 2 6, 2009; Montreal, Canada. IDEXX RealPCR Directory 23

26 Canine and Feline RealPCR Tests Additional Canine and Feline Tests Blood Donor RealPCR Panel with FeLV/FIV by ELISA Feline 2908 $ Anaplasma spp., Bartonella spp., Cytauxzoon felis, Ehrlichia spp., feline coronavirus (FCoV), Feline Hemotropic Mycoplasma, FeLV and FIV RealPCR tests, FeLV antigen and FIV antibody by ELISA 1 ml serum for ELISAs, 2 ml EDTA whole blood (LTT) for RealPCR tests; keep refrigerated. Collect specimens prior to antibiotic administration. Blood Donor RealPCR Panel with Lab 4Dx Plus Test Canine* 2909 $95.59 Anaplasma spp., Babesia spp., Bartonella spp., Brucella canis, Canine Hemotropic Mycoplasma and Ehrlichia spp. RealPCR tests, Leishmania spp. Quant RealPCR test, Lab 4Dx Plus Test. Includes quantification of Leishmania if PCR positive. 1 ml serum for ELISAs, 2 ml EDTA whole blood (LTT) for RealPCR tests; keep refrigerated. Collect specimens prior to antibiotic administration. Blood Donor RealPCR Panel Canine 2939 $83.63 Anaplasma spp., Babesia spp., Bartonella spp., Brucella canis, Canine Hemotropic Mycoplasma and Ehrlichia spp. RealPCR tests, Leishmania spp. Quant RealPCR test. Includes quantification of Leishmania if PCR positive. 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. Brucella canis RealPCR Test 2865 $ ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. NEW Candida spp. RealPCR Test 3582 $48.29 Ideal specimen depends on clinical manifestation. Keep all specimens refrigerated. Skin manifestations: (including granulomatous rhinitis, stomatitis, otitis externa, corneal ulceration and skin or nail lesions): Swab or scraping of affected region (preferred) or hair (including roots) from affected region. Collect material from active border of affected area using a sterile swab or scalpel blade. If collected with a blade, wipe material onto a sterile swab. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Urinary manifestations: 2 ml (0.1 ml minimum) urine in a sterile container GI manifestations: 5 g (1 g minimum) fresh feces in a sterile container Systemic, nonspecific manifestations: 2 ml EDTA whole blood (LTT) See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 24 IDEXX RealPCR Directory

27 Canine and Feline RealPCR Tests Additional Canine and Feline Tests Distemper Virus (CDV) Quant RealPCR Test Canine 3265 $71.00 Add-on $67.00 Includes quantification of distemper viral particles if PCR positive. Note: Use for dogs with respiratory signs consistent with canine distemper virus that have been vaccinated with a modified live vaccine within the previous 4 weeks or for whom a quantitative value is required. For dogs with clinical manifestations requiring other nonrespiratory specimen types or in dogs for which vaccine interference is not a concern, please see Distemper Virus (CDV) RealPCR Test Canine (Test Code 2265). The Distemper Virus (CDV) Quant RealPCR Test Canine can only be performed on swabs from respiratory mucosal surfaces. Deep pharyngeal swab (with visible organic material on swab; please rub firmly) and a conjunctival swab (wipe eye clean, swab inside of eyelid) in the same tube. Please submit dry plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube (keep refrigerated). Distemper Virus (CDV) RealPCR Test Canine 2265 $61.79 Ideal specimen depends on clinical manifestation. Keep all specimens refrigerated. For neurological manifestations: 2 ml EDTA whole blood (LTT), 0.5 ml (0.1 ml minimum) CSF and a conjunctival swab (preferred); or 2 ml EDTA whole blood (LTT), 2 ml urine and a conjunctival swab. For conjunctival swab, wipe eye clean and swab inside of eyelid. Please submit dry, plastic-stemmed swab, without transport media, in an RTT or an empty, sterile tube. For respiratory manifestations: Deep pharyngeal swab (with visible organic material on swab; please rub firmly) and a conjunctival swab (wipe eye clean, swab inside of eyelid), in the same tube. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. For GI manifestations: 2 ml EDTA whole blood (LTT) and 5 g (1 g minimum) fresh feces in a sterile container. With no distinct clinical manifestations: 2 ml EDTA whole blood (LTT); conjunctival swab (wipe eye clean, swab inside of eyelid). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Feline Coronavirus (FCoV) RealPCR Test 1714 $ ml (0.1 ml minimum) pleural or abdominal effusion (preferred specimen), CSF, EDTA whole blood (LTT), 5 g (1 g minimum) fresh feces in a sterile container; keep refrigerated. NEW Feline Viral RealPCR Panel 3543 $67.79 Feline calicivirus, feline coronavirus (FCoV), FeLV and FIV RealPCR tests Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV infections. 2 ml EDTA whole blood (LTT): keep refrigerated IDEXX RealPCR Directory 25

28 Canine and Feline RealPCR Tests Additional Canine and Feline Tests FeLV and FIV RealPCR Panel 3356 $70.95 Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV and FIV infections. 2 ml EDTA whole blood (LTT); keep refrigerated. FeLV RealPCR Test 2635 $48.29 Note: Serology (SNAP test or reference laboratory ELISA) is recommended for initial screening for FeLV infections. 2 ml EDTA whole blood (LTT); keep refrigerated NEW Fever of Unknown Origin RealPCR Panel (Comprehensive) Canine 3539 $ Anaplasma spp., Babesia spp., Bartonella spp., Blastomyces dematitidis, Brucella canis, Coccidioides spp., Cryptococcus spp., Ehrlichia spp., Hepatozoon spp., Histoplasma capsulatum, Leishmania spp. Quant, Leptospira spp., Neospora caninum, Rocky Mountain spotted fever (Rickettsia rickettsii), Toxoplasma gondii and Trypanosoma cruzi RealPCR tests. Includes quantification of Leishmania if PCR positive. 2 ml EDTA whole blood (LTT) and 2 ml urine in a sterile container; keep refrigerated. Collect specimens prior to antibiotic administration. NEW Fever of Unknown Origin RealPCR Panel (Comprehensive) Feline 3540 $ Anaplasma spp., Bartonella spp., Cryptococcus spp., Cytauxzoon felis, Ehrlichia spp., feline calicivirus, feline coronavirus (FCoV), feline hemotropic mycoplasma (FHM), feline panleukopenia virus, FeLV, FIV, Salmonella spp. and Toxoplasma gondii RealPCR tests 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. NEW Fever of Unknown Origin RealPCR Panel (Standard) Canine 3541 $76.50 Anaplasma spp., Babesia spp., Bartonella spp., Brucella canis, Cryptococcus spp., Ehrlichia spp., Neospora caninum, Rocky Mountain spotted fever (Rickettsia rickettsii) and Toxoplasma gondii RealPCR tests 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. NEW Fever of Unknown Origin RealPCR Panel (Standard) Feline 3542 $77.50 Anaplasma spp., Bartonella spp., Cryptococcus spp., Cytauxzoon felis, Ehrlichia spp., feline calicivirus, feline coronavirus (FCoV), FeLV, FIV and Toxoplasma gondii RealPCR tests 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic administration. FIV RealPCR Test 2866 $61.79 FIV subtype A, B, C, D and F RealPCR tests 2 ml EDTA whole blood (LTT); keep refrigerated See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 26 IDEXX RealPCR Directory

29 Canine and Feline RealPCR Tests Additional Canine and Feline Tests NEW Hip Dysplasia DNA Dysgen Test * 3537 $ PCR for seven genetic markers for predisposition to hip dysplasia in the Labrador retriever 2 ml EDTA whole blood (LTT); keep refrigerated 7 14 working days NEW Ringworm RealPCR Panel 3565 $57.29 Trichophyton spp. and Microsporum spp. RealPCR tests Skin scrapings in an RTT or empty, sterile tube (preferred), hair with follicles or nails with nail bed scrapings in sealed fungal envelope or sterile container; keep refrigerated NEW Uveitis RealPCR Panel Feline 3544 $59.50 Bartonella spp., Cryptococcus spp., feline coronavirus (FCoV), feline herpesvirus type 1 (FHV-1), FeLV, FIV and Toxoplasma gondii RealPCR tests 0.5 ml (0.1 ml minimum) aqueous humor (preferred specimen) or 2 ml EDTA whole blood (LTT); keep refrigerated. Collect specimen prior to antibiotic or antifungal administration. *Send-out test. Fee subject to change. IDEXX RealPCR Directory 27

30 Equine RealPCR Tests Only IDEXX offers the equine practitioner equine RealPCR tests and panels designed to detect some of the most challenging infectious diseases affecting horses today. Gastrointestinal Disease The Lawsonia intracellularis Antibody by IPMA is available in combination with the Equine Diarrhea RealPCR Panel (Comprehensive) or with the Lawsonia intracellularis RealPCR Test. Combining serology with PCR testing increases your ability to detect subclinical carriers of the causative agent of equine proliferative enteropathy (EPE). IDEXX Equine Diarrhea RealPCR Panels provide comprehensive, accurate identification of common gastrointestinal pathogens. Consider testing the following: Foals and adult horses with diarrhea or unexplained weight loss Emergency surgical cases presurgery New horses entering a farm or hospital for biosecurity purposes Gastrointestinal disease specimen requirements unless indicated otherwise: 5 g (1 g minimum) fresh feces in a sterile container (keep refrigerated). Collect specimens prior to antibiotic administration. If panel includes Lawsonia intracellularis antibody by IPMA, also submit 1 ml serum. RealPCR results in 1 4 working days; 7 10 working days for Lawsonia serology, allow additional time for culture if indicated Equine Diarrhea RealPCR Panel (Comprehensive) $ Specimens $ or More Specimens $69.29 Clostridium difficile toxin A gene, Clostridium difficile toxin B gene, Clostridium perfringens alpha toxin (CPA) gene, Cryptosporidium spp., equine coronavirus, equine rotavirus, Lawsonia intracellularis, Neorickettsia risticii (Potomac horse fever), Rhodococcus equi and Salmonella spp. RealPCR tests. If positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Equine Diarrhea RealPCR Panel (Comprehensive) with Lawsonia intracellularis Antibody 3381 $ Clostridium difficile toxin A gene, Clostridium difficile toxin B gene, Clostridium perfringens alpha toxin (CPA) gene, Cryptosporidium spp., equine coronavirus, equine rotavirus, Lawsonia intracellularis, Neorickettsia risticii (Potomac horse fever), Rhodococcus equi and Salmonella spp. RealPCR tests and Lawsonia intracellularis antibody by IPMA. If positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Equine Diarrhea RealPCR Panel (Standard) $ Specimens $ or More Specimens $63.79 Clostridium difficile toxin A gene, Clostridium difficile toxin B gene, Clostridium perfringens alpha toxin (CPA) gene, equine rotavirus, Lawsonia intracellularis and Salmonella spp. RealPCR tests. If positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Lawsonia intracellularis Panel 3379 $67.90 Lawsonia intracellularis antibody by IPMA, Lawsonia intracellularis RealPCR test, total protein See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 28 IDEXX RealPCR Directory

31 Equine RealPCR Tests Gastrointestinal Disease Clostridium difficile Toxins A and B Genes RealPCR Panel 2933 $70.95 Clostridium perfringens Alpha Toxin (CPA) Gene RealPCR Test 2646 $48.26 Cryptosporidium spp. RealPCR Test 2630 $48.26 Equine Coronavirus RealPCR Test 2932 $61.91 Equine Rotavirus RealPCR Test 2931 $61.91 Lawsonia intracellularis RealPCR Test 2930 $48.26 Neorickettsia risticii (Potomac Horse Fever) RealPCR Test Equine 2934 $48.26 Rhodococcus equi RealPCR Test without Culture 2940 $48.26 Salmonella spp. RealPCR Test with Culture (ID Only) Equine $ Specimens $ or More Specimens $65.09 Includes culture (organism ID only) on selective media for Salmonella. Salmonella spp. RealPCR Test with Reflex Culture (if Indicated) Equine $ Specimens $ or More Specimens $43.59 If the RealPCR test is positive for Salmonella spp., a culture with susceptibilities on selective media for Salmonella will be automatically performed at no additional charge. Equine coronavirus outbreaks Equine coronavirus (ECoV) has traditionally been thought of as a disease in individual foals. However, most of the positive RealPCR results for ECoV at IDEXX Reference Laboratories are in adult horses over 5 years of age (57%) with only 27% reported in foals < 6 months. This is consistent with the recent outbreaks, which are reported to occur in adult horses. 1 Geographic distribution of ECoV outbreaks ECoV Outbreaks ECoV Sporadic Positives Reference 1. Pusterla N, Mapes S, Wademan C, et al. Emerging outbreaks associated with equine coronavirus in adult horses. Vet Microbiol. 2013;162(1); IDEXX RealPCR Directory 29

32 Equine RealPCR Tests Neurologic Disease Diagnosing neurologic disease in horses can be a significant challenge and requires fast, accurate test results. Performing the Equine Neurologic Disease Panel provides you with answers to the major infectious pathogens that can cause neurologic disease in horses from one specimen submission. Consider testing horses exhibiting the following signs of neurologic disease: Asymmetrical ataxia Stiff, stilted movements Changes in personality or behavior Stumbling Head shaking Muscle deterioration Head tilt with poor balance Difficulty swallowing or loss of appetite Respiratory signs Neurologic disease specimen requirements unless indicated otherwise: 7 ml EDTA whole blood or nasal swabs (one from each nostril). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. Equine Neurologic Disease Panel 2619 $ EPM by Western blot (serum), West Nile virus IgM antibody by capture ELISA, equine herpesvirus type 1 (EHV-1) RealPCR test 7 ml EDTA whole blood or nasal swabs (for EHV-1 RealPCR Test) and 2 ml serum (no hemolysis or lipemia). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. 2 5 working days Equine Herpesvirus Type 1 (EHV-1) RealPCR Test 2566 $ Specimens $ or More Specimens $34.90 Note: Nasal swabs are used to detect animals shedding the virus or that were recently exposed to a confirmed case. A whole blood specimen is recommended from symptomatic animals to detect viremia. Equine Herpesvirus Types 1 (EHV-1) and 4 (EHV-4) RealPCR Tests 2699 $ Specimens $ or More Specimens $44.59 Note: Nasal swabs are used to detect animals shedding the virus or that were recently exposed to a confirmed case. A whole blood specimen is recommended from symptomatic animals to detect viremia. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 30 IDEXX RealPCR Directory

33 Equine RealPCR Tests Reproductive Disease Diagnosing reproductive failure in mares, including abortion, postpartum sickness or infertility, can be a significant challenge for the equine practitioner and requires fast and accurate test results. Performing the equine reproductive health RealPCR panels provides you with unparalleled depth to test for the major infectious agents that can cause reproductive problems in mares. Consider testing: Cases of abortion storms, individual abortions and stillbirths Infertile mares Cases of prolonged diffuse or focal-type placentitis Live foals with significant health problems, including necrotizing enterocolitis and neonatal maladjustment syndrome Postpartum sick mares Reproductive disease specimen requirements unless indicated otherwise: Endometrial swab or Cytobrush, swab from clitoral fossa and sinus, and 2 ml EDTA whole blood (LTT); keep refrigerated. If available, for abortion panels, also include 2 ml (0.1 ml minimum) umbilical cord blood (LTT), fresh placental tissue (from cotyledons), fresh fetal spleen and/or 2 ml fetal stomach contents. Submit tissue, fluids and dry, plastic-stemmed swabs, without transport media, in RTTs or empty, sterile containers. Collect specimens prior to antibiotic administration. When ordering a panel that includes a biopsy, also submit placental or endometrial biopsy specimen in 10% formalin. NEW Abortion RealPCR Panel with EAV and CEM Equine 3562 $ Amycolatopsis spp., Bartonella spp., Candida albicans, Crosiella equi, equine arteritis virus (EAV), equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4), Leptospira spp., Salmonella spp., Streptococcus dysgalactiae subsp. equisimilis, Streptococcus equi subsp. zooepidemicus and Taylorella equigenitalis (CEM) RealPCR tests Note: Placental or endometrial biopsy is recommended in addition to the RealPCR panel (see Abortion RealPCR Panel with EAV and CEM and Biopsy Equine [Test Code 3563]). NEW Abortion RealPCR Panel with EAV and CEM and Biopsy Equine 3563 $ Abortion RealPCR Panel with EAV and CEM Equine, biopsy with microscopic description (placental or endometrial) Note: Biopsy will be read by a pathologist with a special interest in equine reproductive pathology. NEW Abortion/Postpartum Sick Mare RealPCR Panel Equine 3558 $86.95 Amycolatopsis spp., Bartonella spp., Candida albicans, Crossiela equi, equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4), Leptospira spp., Salmonella spp., Streptococcus dysgalactiae subsp. equisimilis and Streptococcus equi subsp. zooepidemicus RealPCR tests Note: Placental or endometrial biopsy is recommended in addition to the RealPCR panel (see Abortion/Postpartum Sick Mare RealPCR Panel with Biopsy Equine [Test Code 3559]). IDEXX RealPCR Directory 31

34 Equine RealPCR Tests Reproductive Disease NEW Abortion/Postpartum Sick Mare RealPCR Panel with Biopsy Equine 3559 $ Abortion/Postpartum Sick Mare RealPCR Panel Equine, biopsy with microscopic description (placental or endometrial) Note: Biopsy will be read by a pathologist with a special interest in equine reproductive pathology. NEW Infertile Mare RealPCR Panel 3560 $77.95 Amycolatopsis spp., Bartonella spp., Candida albicans, Crossiela equi, Leptospira spp., Salmonella spp., Streptococcus dysgalactiae subsp. equisimilis and Streptococcus equi subsp. zooepidemicus RealPCR tests Note: Uterine cytology with guarded swab or endometrial biopsy (preferred) is recommended in addition to the RealPCR panel (see Infertile Mare RealPCR Panel with Biopsy [Test Code 3561]). NEW Infertile Mare RealPCR Panel with Biopsy 3561 $ Infertile Mare RealPCR Panel, biopsy with microscopic description (endometrial) Note: Biopsy will be read by a pathologist with a special interest in equine reproductive pathology. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 32 IDEXX RealPCR Directory

35 Equine RealPCR Tests Respiratory Disease New in 2014 is a Strangles RealPCR Screen, allowing for simultaneous testing of all three Streptococcus strains implicated in strangles-like disease in horses. The expanded Comprehensive Equine Respiratory RealPCR Panel provides rapid, comprehensive diagnosis of critical respiratory pathogens, including the most commonly identified equine herpesvirus types 2 (EHV-2) and 5 (EHV-5). Consider testing: Foals and adult horses with respiratory disease or neurologic signs Equine athletes that are commingled with other horses at competitions New horses entering a farm or hospital for biosecurity purposes Prevalence of each component in the Comprehensive Equine Respiratory RealPCR Panel The Comprehensive Equine Respiratory RealPCR Panel provides testing for the most common respiratory pathogens. From 384 specimens collected and tested during a 5-month period, using the new comprehensive panel, the following was observed: Results were positive for any one of the nine infectious agents 35.8% of the time. Results were positive for coinfections with two or more infectious agents 7.8% of the time. The most commonly identified pathogens were equine herpesvirus type 2 (EHV-2) and type 5 (EHV-5), available in the Comprehensive Equine Respiratory RealPCR Panel. EHV EHV Equine Adenovirus 24.5 Equine Influenza Virus (EIV/H3N8) 19.5 Streptococcus equi subsp. equi 12.5 EHV Equine Rhinitis B Virus 4.1 EHV-1 (wild-type) 3.9 EHV-1 (neuropathogenic) 3.4 Equine Rhinitis A Virus 2.0 Equine Arteritis Virus (EAV) 0.0 n=384 Respiratory disease specimen requirements unless indicated otherwise: Deep nasopharyngeal swabs (one from each nostril). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. Collect specimen prior to antibiotic administration. RealPCR results in 1 4 working days; allow additional time for culture if indicated IDEXX RealPCR Directory 33

36 Equine RealPCR Tests Respiratory Disease Equine Respiratory RealPCR Panel (Comprehensive) 3324 $ Equine adenovirus, equine influenza virus (EIV/H3N8), equine herpesvirus type 1 (EHV-1), type 2 (EHV-2), type 4 (EHV-4) and type 5 (EHV-5), equine rhinitis A virus (ERAV), equine rhinitis B virus (ERBV) and Streptococcus equi subsp. equi RealPCR tests. Includes culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. Equine Respiratory RealPCR Panel (Standard) 2740 $ Equine influenza virus (EIV/H3N8), equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4) and Streptococcus equi subsp. equi RealPCR tests. Includes culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. Equine Respiratory RealPCR Panel (Standard) with EAV 2741 $ Equine arteritis virus (EAV), equine influenza virus (EIV/H3N8), equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4) and Streptococcus equi subsp. equi RealPCR tests; includes culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. Equine Respiratory RealPCR Panel (Standard) with Rhinitis 3325 $ Equine influenza virus (EIV/H3N8), equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4), equine rhinitis A virus (ERAV), equine rhinitis B virus (ERBV) and Streptococcus equi subsp. equi RealPCR tests. Includes culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. NEW Equine Herpesvirus RealPCR Panel 3548 $67.79 Equine herpesvirus type 1 (EHV-1), type 2 (EHV-2), type 4 (EHV-4) and type 5 (EHV-5) RealPCR tests Note: Nasal swabs are used to detect animals shedding the virus or that were recently exposed to a confirmed case. A whole blood specimen is recommended from symptomatic animals to detect viremia. 2 ml EDTA whole blood and/or deep nasopharyngeal swabs (one from each nostril). Please submit dry, plastic-stemmed swabs without transport media, in an RTT or empty, sterile tube; keep refrigerated. NEW Strangles RealPCR Screen 1 5 Specimens 3549 $ Specimens $ or More Specimens $35.00 Streptococcus dysgalactiae subsp. equisimilis, Streptococcus equi subsp. equi, Streptococcus equi subsp. zooepidemicus RealPCR tests. If positive for Streptococcus equi subsp. equi, a culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. will be automatically performed at no additional charge. Note: Culture will only be performed if an additional BD Culturette (culture swab in transport media) is submitted. One Culturette (culture swab in transport media) for aerobic culture if indicated; and guttural pouch or nasal wash in a sterile tube (preferred) or deep nasopharyngeal swabs (one from each nostril) for RealPCR tests; keep refrigerated. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 34 IDEXX RealPCR Directory

37 Equine RealPCR Tests Respiratory Disease Equine Arteritis Virus (EAV) RealPCR Test 2739 $ Equine Herpesvirus Type 1 (EHV-1) RealPCR Test 2566 $ Specimens $ or More Specimens $34.90 Note: Nasal swabs are used to detect animals shedding the virus or that were recently exposed to a confirmed case. A whole blood specimen is recommended from symptomatic animals to detect viremia. 2 ml EDTA whole blood and/or deep nasopharyngeal swabs (one from each nostril). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. Equine Herpesvirus Types 1 (EHV-1) and 4 (EHV-4) RealPCR Tests 2699 $ Specimens $ or More Specimens $44.59 Note: Nasal swabs are used to detect animals shedding the virus or that were recently exposed to a confirmed case. A whole blood specimen is recommended from symptomatic animals to detect viremia. 2 ml EDTA whole blood or deep nasopharyngeal swabs (one from each nostril). Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube; keep refrigerated. Equine Influenza Virus (EIV/H3N8) RealPCR Test 2738 $62.14 Rhodococcus equi RealPCR Test $ Specimens $ or More Specimens $38.59 Includes culture (organism ID only) on selective media for R. equi. Note: The Rhodococcus equi RealPCR Test detects virulent strains containing the virulence plasmid (VapA) associated with clinical disease in horses. For respiratory specimens, the test also includes culture confirmation of the presence of R. equi bacteria (virulent and avirulent strains). Please see Rhodococcus equi RealPCR Test without Culture (Test Code 2940) for testing fecal specimens in horses with gastrointestinal manifestations ml tracheal wash fluid in a sterile tube without preservatives; keep refrigerated and send with cold pack within 24 hours of collection. Collect specimen prior to antibiotic administration. Streptococcus equi subsp. equi RealPCR Test with Culture 1 Specimen $ Specimens $ or More Specimens $56.59 Includes culture (organism ID only) on selective media for ß-hemolytic Streptococcus spp. Guttural pouch or nasal wash in a sterile tube (preferred) or deep nasopharyngeal swabs (one from each nostril) for RealPCR tests; keep refrigerated. Please submit dry, plastic-stemmed swabs without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. IDEXX RealPCR Directory 35

38 Equine RealPCR Tests Additional Equine Tests Anaplasma spp. RealPCR Test 2824 $48.29 Anaplasma phagocytophilum and Anaplasma platys RealPCR tests 2 ml EDTA whole blood (LTT); keep refrigerated. Collection specimen prior to antibiotic administration. NEW Candida spp. RealPCR Test 3582 $48.29 Ideal specimen depends on clinical manifestation. Keep all specimens refrigerated. Skin manifestations (including granulomatous rhinitis, stomatitis, otitis externa, corneal ulceration and skin or nail lesions): Swab or scraping of affected region (preferred) or hair (including roots) from affected region. Collect material from active border of affected area using a sterile swab or scalpel blade. If collected with a blade, wipe material onto a sterile swab. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Urinary manifestations: 2 ml (0.1 ml minimum) urine in a sterile container GI manifestations: 5 g (1 g minimum) fresh feces in a sterile container Systemic, nonspecific manifestations: 2 ml EDTA whole blood (LTT) NEW Corynebacterium pseudotuberculosis (Pigeon Fever) RealPCR Test 3564 $48.29 Skin biopsy (fresh tissue in sterile container), swab of purulent material from abscess, aspirate of peritoneal fluid (when internal abscess is suspected), skin scraping from affected area or insect vector (including housefly) from affected farm in a sterile container. Submit dry, plastic-stemmed swabs, without transport media, in an RTT or empty, sterile container. Keep specimens refrigerated. Collect specimens prior to antibiotic administration. See RealPCR Specimen Collection Guidelines (page 5) for detailed protocols and additional specimen options. 36 IDEXX RealPCR Directory

39 Exotics RealPCR Tests Infectious diseases in small mammal pocket pets, such as mice, rats, hamsters, guinea pigs and rabbits, commonly present with nonspecific signs, progress rapidly and are often fatal. Early treatment directed against the causative organism increases the likelihood of a positive outcome. The new exotics RealPCR panels make it possible to test for multiple organisms with a rapid turnaround time. Indications for testing include the following: Loss of appetite Lethargy Diarrhea Hunched posture Ruffled hair coat or general unthriftiness Ocular discharge NEW Guinea Pig Acute Disease RealPCR Panel 3580 $65.90 Bordetella bronchiseptica, guinea pig adenovirus, Salmonella spp. and Streptococcus equi subsp. zooepidemicus RealPCR tests Oral cavity swab and fecal pellet in a sterile container; keep refrigerated. Please submit dry, plastic-stemmed swab, without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. NEW Hamster Wet Tail RealPCR Panel 3579 $65.90 Clostridium difficile toxin A gene, Clostridium difficile toxin B gene, Clostridium perfringens, Clostridium piliforme, Lawsonia intracellularis and Salmonella spp. RealPCR tests Fecal pellet in a sterile container; keep refrigerated. Collect specimens prior to antibiotic administration. NEW Mouse ADR RealPCR Panel 3578 $65.90 CAR Bacillus spp., Citrobacter rodentium, fur mites, Mycoplasma pulmonis and Salmonella spp. RealPCR tests Oral cavity swab, fur swab and fecal pellet in a sterile container; keep refrigerated. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. NEW Rabbit ADR RealPCR Panel 3581 $65.90 Bordetella bronchiseptica, Clostridium difficile toxin A gene, Clostridium difficile toxin B gene, Clostridium perfringens and Salmonella spp. RealPCR tests Oral cavity swab and fecal pellet in a sterile container; keep refrigerated. Please submit dry, plastic-stemmed swab, without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. NEW Rat ADR RealPCR Panel 3576 $65.90 CAR Bacillus spp., fur mites, Mycoplasma pulmonis, rat coronavirus, Salmonella spp. and Streptobacillus moniliformis RealPCR tests Oral cavity swab, fur swab and fecal pellet in a sterile container; keep refrigerated. Please submit dry, plastic-stemmed swabs, without transport media, in an RTT or an empty, sterile tube. Collect specimens prior to antibiotic administration. IDEXX RealPCR Directory 37

40 Notes 38 IDEXX RealPCR Directory

41 Notes IDEXX RealPCR Directory 39

42 Alphabetical Index by Organism Amycolatopsis spp Anaplasma spp , 26, 36 Angiostrongylus vasorum (French heartworm) Babesia spp , 26 Bartonella spp , 19 22, Bordetella bronchiseptica , 37 Borrelia spp. (Lyme disease) , Blastomyces dematitidis 11, 17, 26 Brucella canis , 24, 26 Campylobacter coli Campylobacter jejuni 7 8, Candida spp , 31 32, 36 Canine Adenovirus Type Canine Circovirus. 7 9 Canine Enteric Coronavirus (CECoV) Canine Hemotropic Mycoplasma Canine Herpesvirus Type 1 (CHV 1) Canine Influenza Virus (H3N8) Canine Lungworm 14 Canine Parainfluenza Virus Canine Pneumovirus Canine Respiratory Coronavirus (CRCoV) CAR Bacillus Chlamydophila felis Citrobacter rodentium Clostridium difficile Toxin A Gene , 37 Clostridium difficile Toxin B Gene , 37 Clostridium perfringens Alpha Toxin (CPA) Gene , Clostridium perfringens Enterotoxin (CPE) Gene Clostridium piliforme 37 Coccidioides spp. 11, 17, 26 Corynebacterium pseudotuberculosis (Pigeon Fever) Crenosoma vulpis (Fox Lungworm) Crossiela equi Cryptococcus spp , 17, Cryptosporidium spp , Cytauxzoon felis , 24, 26 Distemper Virus (CDV) Canine , 11 16, 25 Ehrlichia spp Equine Adenovirus Equine Arteritis Virus (EAV) 31, Equine Coronavirus Equine Herpesvirus Equine Influenza Virus (EIV/H3N8) Equine Protozoal Myeloencephalitis (EPM) IDEXX RealPCR Directory

43 Equine Rhinitis Virus Equine Rotavirus Feline Calicivirus , Feline Coronavirus (FCoV) , 11 13, Feline Hemotropic Mycoplasma , 26 Feline Herpesvirus Type 1 (FHV 1) , 27 Feline Panleukopenia Virus , 12 13, 26 FeLV 11 13, 19 22, FIV , 19 22, Fur Mites Giardia spp Guinea Pig Adenovirus Haemobartonella See Feline Hemotropic Mycoplasma , 26 Hepatozoon spp , 26 Histoplasma capsulatum 11, 17, 26 H1N1 Pandemic Influenza Virus Lawsonia intracellularis , 37 Leishmania spp , 19 24, 26 Leptospira spp , 12 13, 21, 26, Microsporum spp Minute Virus (parvovirus type 1) Mycoplasma cynos Mycoplasma felis Mycoplasma pulmonis Neorickettsia risticii , Neospora spp , 26 Parvovirus 2 (CPV 2) Canine 7 9 Pigeon Fever See Corynebacterium pseudotuberculosis 36 Potomac Horse Fever See Neorickettsia risticii , Rat Coronavirus Rhodococcus equi , 35 Rickettsia spp , 26 Ringworm Rocky Mountain Spotted Fever (Rickettsia risticii) , 26 Rotavirus , Salmonella spp , 12 13, 26, 28 29, 31 32, 37 Streptobacillus moniliformis Streptococcus canis Streptococcus dysgalactiae subsp. equisimilis , Streptococcus equi subsp. equi Streptococcus equi subsp. zooepidemicus , 31 32, 34, 37 Taylorella equigenitalis (CEM) Toxoplasma gondii , 11 13, Trichophyton spp. 27 Tritrichomonas foetus West Nile Virus , 30 IDEXX RealPCR Directory 41

44 IDEXX Reference Laboratories Standard Terms and Conditions Unless otherwise agreed in an agreement signed by IDEXX Reference Laboratories (collectively, IDEXX, we, us or our ), laboratory testing and consulting services (data collection, analysis and interpretation, and reference laboratory services) that we provide to you, the client, are subject solely to the terms and conditions stated herein and in any terms appearing on the back of our invoices and billing statements to you. The terms and conditions stated herein control in the event of any conflict. Confidentiality. We agree to maintain in confidence all of your proprietary and nonpublic materials, data, reports, plans, records, technical and other information and to use such confidential information only for the purpose of performing analyses of specimens and providing reports on our findings to you. We shall protect your confidential information by using the same degree of care, but not less than a reasonable degree of care, to prevent the unauthorized use, dissemination or publication of the confidential information as we use to protect our own confidential information of a like nature. In any instance where information is subpoenaed by, and must be released to, a governmental agency, or is otherwise required to be disclosed pursuant to law or regulation, we will promptly notify you. You agree not to use the IDEXX name and/or data in any manner that might cause harm to our reputation and/or business. Under no circumstances is the name of IDEXX to be published either alone or in association with that of any other party without our approval in writing. Payment Terms. All fees are charged or billed directly to you. Payment in advance is required for all clients except those whose credit has been established with our company. For clients with approved credit, our standard terms are net the 25th day of the month following the date of invoice. Overdue payments are subject to finance charges of the lower of 1½% per month or the maximum interest rate allowed by law. We may change payment terms at any time or revoke any credit previously extended. We must agree in writing to any extension of payment beyond our standard terms. If at any time you have not paid all amounts due, other than amounts disputed in good faith, then without prejudice to any other rights we may suspend all work for you, including warranty service. If you default in payment for services rendered, you are responsible for reasonable collection and/or legal fees. Delivery of Results. Upon timely delivery of specimens, we will use commercially reasonable efforts to meet standard turnaround times. We will advise you if we receive specimens in damaged, contaminated or improperly preserved condition, or which do not meet specimen volume requirements. We assume the risk of loss or damage to a specimen at the time possession of the specimen is delivered to an IDEXX employee. We reserve the right to refuse to accept or to rescind acceptance of any specimen, which in our judgment is likely to pose any unreasonable risk in handling and/or analysis. You represent and warrant that any specimen containing any hazardous substance, which is to be delivered to us, will be packaged, labeled, transported and delivered in accordance with applicable laws. Quality Assurance. We will perform services consistent with our quality assurance standard operating procedures. It is your exclusive responsibility to confirm that our standard practices will meet your needs before placing any order for work. Retention of Specimens. After we report analytical results, we routinely retain whole blood specimens in our storage facilities for forty-eight (48) hours, and serum specimens for six (6) days, after which we may destroy the specimens. Hazardous Materials. We may return to you unused portions of specimens found or suspected to be hazardous, or to contain hazardous materials according to state or federal guidelines upon completion of the analytical work. We will not accept or analyze human specimens. We may invoice you for the cost of returning the specimen. Specimen Containers. We may provide specimen containers upon request. We reserve the right to charge a fee for specimen containers. All specimens become the property of IDEXX upon delivery to an IDEXX facility. Retention of Reports. Unless otherwise agreed in writing, we shall retain copies of reports for a period of one (1) year, after which we may destroy the reports. Limited Warranty and Limits of Liability. In accepting work, we warrant that we shall provide services in a professional manner using qualified personnel, and we warrant the accuracy of test results for the specimen as submitted. EXCEPT AS STATED IN THIS LIMITED WARRANTY, WE MAKE NO OTHER WARRANTY, REPRESENTATION OR CONDITION, EXPRESS OR IMPLIED, WRITTEN OR ORAL, AND THERE IS NO WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE OR NONINFRINGEMENT. We do not assume, nor do we authorize any employee, agent or other person to assume for us, any other liability in connection with our services. If you qualify as a consumer under applicable law, then you may be entitled to implied warranties allowed by law, limited to the period of the express warranties and the remedies set forth in this limited warranty. Some jurisdictions do not allow limitations on how long an implied warranty lasts, so the above limitations may not apply to you. 42 IDEXX RealPCR Directory

45 We are not liable for failure to perform due to circumstances beyond our reasonable control. UNDER NO CIRCUMSTANCES WILL WE BE LIABLE TO YOU OR ANY OTHER PERSON FOR LOSS OF PROFIT OR USE, SPECIAL, INCIDENTAL, CONSEQUENTIAL, INDIRECT, EXEMPLARY, PUNITIVE OR MULTIPLE DAMAGES, INCLUDING WITHOUT LIMITATION FOR LOSS OF GOODWILL, DATA OR EQUIPMENT OR FOR BUSINESS INTERRUPTION, ARISING OUT OF THE SALE or provision OF OUR SERVICES OR FAILURE OR DELAY IN DELIVERING SUCH SERVICES, WHETHER BASED ON WARRANTY, CONTRACT, TORT OR OTHERWISE, EVEN IF WE WERE ADVISED OF THE POSSIBILITY OF SUCH DAMAGES OR LOSSES. OUR ENTIRE LIABILITY to you in connection with the provision of laboratory testing or consulting services, WHETHER BASED ON WARRANTY, CONTRACT, TORT OR OTHERWISE, SHALL NOT EXCEED THE AMOUNT YOU PAID FOR SUCH laboratory test or consultation service. We accept no legal responsibility for the purposes for which you use our analyses, reports or other services. Some jurisdictions do not allow the exclusion or limitation of special, incidental, consequential, indirect, exemplary, punitive or multiple damages or the limitation of liability to the actual price paid for the product or service, so the above limitations may not apply to you. Our limited warranty gives you specific legal rights, and you may also have other rights that vary from jurisdiction to jurisdiction. We shall not accept any purchase order or other order for work that includes any conditions that vary from the above described Standard Terms and Conditions, and we hereby object to any conflicting terms contained in any acceptance or order submitted by you. Collection and use of personal information. IDEXX collects your personal information in order to provide you with the products and services you request, to inform you about products or services that we think may be of interest to you, and for other limited purposes. IDEXX may disclose personal information to third parties in certain circumstances, including as needed to fulfill your requests or otherwise in accordance with our privacy policies. IDEXX does not disclose personal information to third parties for their own marketing purposes. Please note that your information may be stored and processed in the United States, countries of the European Union, and elsewhere. Full information about IDEXX s privacy policies can be viewed at idexx.com. If you do not want to receive unsolicited commercial information, please contact IDEXX by telephone at or by at fax-unsubscribe@idexx.com. Incoming telephone calls to a laboratory may be monitored for training purposes only. Governing Law; Waiver of Jury Trial. This Agreement and the transactions contemplated hereby, and all related disputes between the parties under or relating to this Agreement, whether in contract, tort or otherwise, shall be governed by the laws of the State of Maine (or Ontario, for Canadian sales), without reference to conflict of laws principles, and any related legal actions must be brought in the court of appropriate jurisdiction in the State of Maine (or in the province of Ontario, for Canadian sales), which shall have exclusive jurisdiction (except that either of us may bring an action for an injunction or similar equitable relief against the other in any proper jurisdiction). You hereby waive any claim of lack of jurisdiction or inconvenient forum. YOU AND WE WAIVE TRIAL BY JURY IN ANY LEGAL ACTION BY OR AGAINST US IN SUCH LEGAL ACTIONS. We each further waive any claims against the other for multiple, punitive or exemplary damages in any legal actions relating to this Agreement. The prevailing party in any such legal actions shall be entitled to an award of its reasonable legal fees and costs. Equal Opportunity/Affirmative Action Notice. We are an equal opportunity/affirmative action employer and comply with all the regulations of executive order and the regulations promulgated thereunder. IDEXX RealPCR Directory 43

46 Notice to veterinarians: IDEXX Reference Laboratories provides consultation and interpretation services on a professional-to-professional basis. Without personally having made a physical examination of and conducted all tests on a patient, IDEXX veterinarians, in providing consultations and interpreting test results, rely on data communicated by you, the primary care veterinarian. By providing consultations, IDEXX does not purport to diagnose or treat your patient. The test protocols and interpretations in this directory are based on recommendations from current veterinary literature and are provided for general guidance only. As with any diagnosis or treatment, you should use clinical discretion with each patient based on a complete evaluation of the patient, including history, physical presentation and complete laboratory data. With respect to any drug therapy or monitoring program, you should refer to product inserts for a complete description of dosages, indications, interactions and cautions. Diagnoses and treatment decisions are the ultimate responsibility of the primary care veterinarian. 3Dx, 4Dx, LabREXX, Quant C 6, RealPCR and SNAP are trademarks or registered trademarks of IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries. LightCycler is a registered trademark of Roche Molecular Systems, Inc. Dysgen Test is a registered trademark of Bioiberica. All other product and company names and logos are trademarks of their respective holders. PCR testing is a service performed pursuant to an agreement with Roche Molecular Systems, Inc IDEXX Reference Laboratories, Inc. All rights reserved The IDEXX Privacy Policy is available at idexx.com. 44 IDEXX RealPCR Directory

47 Save the couch, the carpet, your clients sanity and 40% Quickly target and treat the cause of infectious diarrhea with an add-on RealPCR panel. Get definitive results when the cause of chronic, acute or intermittent diarrhea is unknown. The IDEXX Canine and Feline Diarrhea RealPCR Panels screen for several of the most common infectious agents with just a single fecal sample. Begin treatment quickly with results in just. Target the cause of infection for tailored, effective treatment. Relieve patients symptoms and pet-owner anxiety sooner for healthier animals and more satisfied clients. Don t wait! Try an IDEXX diarrhea RealPCR panel on your next sick patient. Convenient add-on codes may be ordered with any fecal ova and parasites or fecal culture. Test Code and Name Add-on Diarrhea RealPCR Panel (Comprehensive) Canine Add-on Diarrhea RealPCR Panel (Comprehensive) Feline Regular Price Special Price* $99.00 $59.29 $ $61.09 *Offer expires December 31, Discount applies to add-on diarrhea RealPCR panels only. For more information, please call

48 Laboratory Customer Support If you have any questions regarding test codes, turnaround times or pricing, please contact our Laboratory Customer Support Team at , option 1. Expert Feedback When You Need It Our team of internal medicine specialists is always available for a complimentary consultation. Please call , option 4, if you have questions.

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